Purpose: The purpose of this study were to describe of resilience in children with chronic illness and family resilience, and to identify their correlations. Method: Data was collected from 108 children and their families, being treated by hospitals C and K in Seoul, who are diagnosed with nephrotic syndrome, IgA nephritis, diabetes, asthma at least six months ago. Descriptive, t-test, One-way ANOVA, and Pearson's Correlation were done. Result: The mean score of resilience in children was 101.31 and family resilience was 60.14. The variable which showed a statistically meaningful difference in the resilience in children according to a general characteristic was the gender of a child (t=6.209, p<.05), diagnosis (F= 6.315, p<.01), age of a mother (t=2.237, p<.05), and school grade (F=12.838, P<.01). In terms of the family resilience according to a general characteristic, the variable showing a statistically meaningful difference was the order of sibling (F=13.468, p<.01). There was significant positive resilience in children between family resilience (r=.356, p<.01). Conclusions: In this study we proposed the implement programs for the increase of the resilience in children with chronic illness. In order to give a positive effect on the resilience in children, implement for the increase of the family resilience is also proposed.
Journal of Korean Academy of Fundamentals of Nursing
/
v.25
no.3
/
pp.197-209
/
2018
Purpose: To examine the effects of auricular acupressure on symptoms of patients with allergic rhinitis and their quality of life. Methods: A quasi experimental was used with a nonequivalent control group pretest-posttest method involving 56 adult outpatients who were seen in the Allergy & Asthma clinic at a tertiary referral hospital in Seoul, Korea. The experimental group (n=28) received 2 weeks of auricular acupressure to the Shenmen, wind stream, endocrine, adrenal, and lung acupuncture points; no acupressure was provided to the control group (n=28). Outcome measures included Total Nasal Symptom Score used to assess nasal symptoms, and the Rhinoconjunctivitis Quality of Life Questionnaire to assess the quality of life. Repeated measure ANOVA and independent t-test were used to calculate statistical significance. Results: The experimental group showed significant improvements in terms of allergic rhinitis symptoms (p<.001) and on the Rhinoconjunctivitis Quality of Life Questionnaire (p<.001) compared to the control group. Conclusion: Finding in this study indicate that auricular acupressure can be used as a nursing intervention to alleviate nasal symptoms and improve rhinoconjuctivitis quality of life in allergic rhinitis patients.
Background : It is known that airway inflammation is present in most patients with asthma, but the relationship between symptoms and the severity and nature of airway inflammation has not been established. Cough variant asthma is defined as an asthma in which the dominant symptom is cough, and the condition can be successfully treated with inhaled steroids. This study was performed to evaluate the time course of bronchial responsiveness according to an inhaled anti-inflammatory therapy and the factors which affect the resolution of bronchial responsiveness, and an efficacy of nedocromil to cough asthma. Method: A prospective study for the investigation of bronchial responsiveness according to an inhaled anti-inflammatory treatment in sixty-one cough asthmatics was performed. Twenty-three entered budesonide ($400{\mu}g{\times}2/day$), twenty-two entered nedocromil ($4mg{\times}2/day$) and sixteen patients entered combined group. The bronchial hyperresponsiveness (BHR) was estimated by methacholine challenge test using counted breath method. The symptom was estimated by 'symptom score'. Reevaluation of BHR and symptom was performed at 2 month after treatment, and if BHR was not resoluted at this time, regarded as a non-responder, and then follow-up of BHR and symptom was performed at 4- and/or 6 month after treatment. Results: The improvement of BHR and symptom was significant in 2 month (p<0.05), but there was no change of them during follow-up period of 4- and/or 6 month in non-responders. In comparison of allergic markers such as serum total IgE, peripheral eosinophil count and skin test reactivity between responders and non-responders, there was no difference in each other. However, in comparison of other factors such as cumulative pack-years, symptom duration, age, gender, and the initial degree of PC20, there was a significant difference in each other(p<0.05). The percent of patients with the resolution of BHR in 2 month was not different in each group(p=0.95). There was no significant difference in the degree of improvement of BHR and symptom in each group. Conclusion: Bronchial responsiveness and symptom was not significantly improved in non-responders during follow-up period of 4- and/or 6 month. The effect of inhaled nedocromil was equivalent to that of inhaled steroid in cough asthmatics, and the response to combined treatment is not superior to that achieved by either of these agents used alone.
Background: The purpose of this study was to examine the causes and pathologic process of chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph by investigating clinicopathologic findings. Method: We studied 25 adults with chronic non-productive cough over a 3-week period with a normal chest radiograph and pulmonary function tests without any other symptoms. Clinical assessment, cough score, chest and sinus radiograph, pulmonary function tests, methacholine challenge, allergic skin prick test, and bronchoscopy for bronchial biopsies were performed. Subjects were then treated with prednesolone 20 to 30 mg/day for 1 to 2 weeks. Results: The experimental group was divided into two subgroups-those infiltrated with eosinophils, and those infiltrated with lymphocytes depending on eosinophil and lymphocyte counts, both of which were respectively higher than those of the control group. Eosinophils infiltrated group had mean numbers of eosinophil of 89.8 $cells/mm^3$ while control group's mean was 0.4 $cells/mm^2$(p=0.005). Lymphocyte infiltrated group was 4 patients whose mean was 84.3 $cells/mm^2$ with 28.4 $cells/mm^2$ of control group(P=0.026). In addition, the mean thickness of the basement membrane of experimental group was $14.20{\pm}5.20{\mu}m$ in contrast of control group whose mean was $3.50{\pm}1.37{\mu}m$(P=0.001). With the methacholine challenge test, 7 of the 21 eosinophil infiltrated subjects were diagnosed with cough variant asthma ; the other 14 with eosinophilic bronchitis. Three subjects with eosinophilic bronchitis were atopic positive (21.4%) with the skin prick test In the lymphocyte dominant group, all four subjects were diagnosed with lymphocytic bronchitis. Cough score was improved after steroid treatment in 22 of 25 subjects in the experimental group (88.0%). Conclusion: These results suggest chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph was associated with airway inflammation by eosinophil and lymphocyte infiltration. The causes for chronic non-productive cough were eosinophilic bronchitis, cough variant asthma, and lymphocytic bronchitis(written in frequency). They further suggest that therapeutic treatment with steroids can provide effective symptomatic relief.
This study was conducted on the nutritional status of 1,805 patients with allergic diseases (atopic dermatitis, allergic rhinitis, and asthma) aged 19 to 64 years according to their state of depression, based on the data from the Korea National Health and Nutrition Examination Survey (KNHANES). The Patient Health Questionnaire-9 (PHQ-9) was used to diagnose depression. Subjects with a score of 10 or more were categorized into the depression group (n=152) and the rest into the non-depression group (n=1,653). The results of this study were as follows: The proportion of women (75.7%) was higher than that of men (24.3%) in the depressed group (P<0.01). In terms of energy intake per 1,000 kcal, both men and women in the depressed group showed a lower energy intake than the non-depressed group and this intake was less than the estimated energy requirement (EER). The nutrient intakes of protein, calcium, phosphorus, iron, vitamin A, thiamine, riboflavin, niacin, folic acid, and vitamin C were below the estimated average requirement (EAR). Also, the intakes of fiber and potassium were less than the adequate intake (AI) (P<0.001). In the lifestyle parameters, the ratio of eating alone at lunch was 54.1%:33.1%, indicating that more than half of the depression group ate alone. In conclusion, it was observed that the nutritional status of allergic disease patients was imbalanced. The nutritional imbalance was due to insufficient energy intake and inadequate intake of nutrients, which was below the average requirements of vitamins and minerals and this was more evident in the depression group than in the non-depression group.
Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.
Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.
Purpose: This study was performed to investigate the relationship between ocular and allergy symptoms in children by environmental pollutants emitted from new constructed building. Methods: Two different types of survey (6-Item Dry Eye Questionnaire and Ocular Surface Disease Index) were used to study dry eye syndromes and ocular subjective symptoms for a six-grade of elementary school students (54 males and 61 females) in newly built buildings in the past three month, located near capital city, Seoul. Atopy and medical history of allergic rhinitis were investigated with using questionnaire for allergy, and also nose itchiness and ocular symptoms were checked as visual analog scale(10-score) with using questionnaire of allergy rhinitis and conjunctivitis under the guideline of ARIA(Allergic Rhinitis Impacts on Asthma). Results: Fifty seven students (50%) from DEQ and 19 students (16.52%) from OSDI were diagnosed as dry eye, and 18 students (15.79%) were diagnosed as dry eye from both questionnaires. It was surveyed that 45 students (39.5%) and 29 students (25.4%) had atopy and allergy rhinitis, respectively. Among 45 students having atopy, 30 students and 8 students were diagnosed as dry eye with using DEQ and OSDI, respectively. And also, 22 students were diagnosed as dry eye by DEQ and 5 students were diagnosed as dry eye by OSDI from 29 students having allergy rhinitis. Among 29 students having both medical history atopy and allergy rhinitis, 15 students detected observable ocular symptom. The complicating allergy symptoms with ocular syndrome were arranged with sneeze, nose itchiness, nose stuffiness, and runny nose in order of frequency. As students recognized eye symptoms, the number of allergy found and student's number were increased proportionally. Conclusions: It was found that children's subjective ocular symptoms were confirmed in the environment as newly built building. The number of student for dry eye was proportionally increased to students having atopy and allergy symptoms.
Background : Various type of psychological and stressful events in life have been reported to have much effect in the onset, progress and exacerbation of psychosomatic disorders such as hypertension, bronchial asthma, peptic ulcer, tension headache, alopecia areata, and atopic dermatitis. However, the nature of the association between stress and psychosomatic disorders remains unclear. Objective : The purpose of this study is to determine the relation of stress and the progress of dermatologic disorder. Method : We examined 30 patients with atopic dermatitis and 30 control subjects with tinea pedis and onychomycosis who visited to Dept. of Dermatology, Chung-Ang University Hospital. To evaluate the stress, we used 'Scale of Life Events' and 'Multidemensional Coping Scale'. Result : 1) The score of life events stress in atopic dermatitis group was significantly higher than that of control group. 2) In the result of coping strategies, the atopic dermatitis group was significantly higher than control group at the active forgetting, positive comparison, and emotional pacification, while in control group religious seeking and accomodation tended to be higher with no statistical significance. Conclusion : These findings suggest that psychosocial stress may play a role in life pattern of atopic dermatitis. But further studies are needed to clarity the exact relationship between stress and psychosomatic disorder.
Background: The problem of cancer, especially lung cancer, is very acute in Bangladesh. The present study was conducted to evaluate the risk of lung cancer among Bangladeshi people based on hereditary, socio-economic and demographic factors. Materials and Methods: This study was carried out in 208 people (patients-104, controls-104) from January 2012 to September 2013 using a structured questionnaire containing details of lung cancer risk factors including smoking, secondhand smoke, tobacco leaf intake, age, gender, family history, chronic lung diseases, radiotherapy in the chest area, diet, obesity, physical activity, alcohol consumption, occupation, education, and income. Descriptive statistics and testing of hypotheses were used for the analysis using SPSS software (version 20). Results: According to this study, lung cancer was more prevalent in males than females. Smoking was the highest risk factor (OR=9.707; RR=3.924; sensitivity=0.8872 and P<0.0001) followed by previous lung disease (asthma, tuberculosis etc.) (OR=7.095; RR=1.508; sensitivity=0.316 and P<0.0001)) for male patients. Highly cooked food (OR=2.485; RR=1.126; sensitivity=0.418 and P=0.004)) and also genetic inheritance (OR=1.93; RR=1.335; sensitivity=0.163 and P=0.138) demonstrated significant correlation with lung cancer as risk factors after these two and alcohol consumption was not prevalent. On the other hand, for female patients, tobacco leaf intake represented the highest risk (OR=2.00; RR=1.429; sensitivity= 0.667 and P=0.5603) while genetic inheritance and highly cooked food also correlate with lung cancer but not so significantly. Socioeconomic status and education level also play important roles in causing lung cancer. Some 78.5% male and 83.3% of female cancer patients were rural residents, while 58.2% lived at the margin or below the poverty line. Most male (39.8%) and female (50.0%) patients had completed only primary level education, and 27.6% male and 33.3% female patients were illiterate. Smoking was found to be more prevalent among the less educated persons. Conclusions: The results obtained in this study indicate the importance of creating awareness about lung cancer risk factors among Bangladeshi people and making appropriate access to health services for the illiterate, poor, rural people.
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